MEDICARE: DR. DANIEL A BILLS DMD, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	22D102250200	NJ

General Provider Information

NPI Number	:	1912054412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL A BILLS DMD, MS

Provider Business Mailing Address
First Line	:	2001 LIBERTY PL
Second Line	:	LAKESIDE BUSINESS PARK
City	:	SICKLERVILLE
State	:	NJ
Zip	:	08081-5707
Country	:	US
Telephone Number	:	856-875-4600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 LIBERTY PL
Second Line	:	LAKESIDE BUSINESS PARK
City	:	SICKLERVILLE
State	:	NJ
Zip	:	08081-5707
Country	:	US
Telephone Number	:	856-875-4600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/08/2007

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